Provider Demographics
NPI:1104149285
Name:COMPLETE REHAB & CHIROPRACTIC CENTER INC
Entity type:Organization
Organization Name:COMPLETE REHAB & CHIROPRACTIC CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BORIS
Authorized Official - Middle Name:
Authorized Official - Last Name:VIERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-264-9467
Mailing Address - Street 1:7575 W FLAGLER ST
Mailing Address - Street 2:SUITE 209
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2470
Mailing Address - Country:US
Mailing Address - Phone:305-264-9647
Mailing Address - Fax:305-264-9648
Practice Address - Street 1:7575 W FLAGLER ST
Practice Address - Street 2:SUITE 209
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2470
Practice Address - Country:US
Practice Address - Phone:305-264-9647
Practice Address - Fax:305-264-9648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-03
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC8023261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFILE 8258OtherAHCA HCC UNIT